Alzheimer's foreseen as a growing problem

Reagan lived with disease 10 years

Alzheimer's disease, the feared ailment that afflicted former President Reagan for a decade before he died Saturday, will be a growing problem as the population ages.

The progressive degenerative disease of the brain currently affects about 4.5 million Americans, and the Alzheimer's Association predicts that by the middle of the century, the numbers will grow to 14 million if a cure or treatment is not found.

"It's particularly devastating because it affects not just the patient, but also loved ones, who often have to provide care as the patient's mind and personality are robbed in the final stage of the disease."

There is no cure, and the only treatment just slows the progression of the disease, named after a German physician who first described the condition in 1906. At first those afflicted with it seem merely forgetful, but gradually they undergo profound memory loss, impaired thinking and personality change.

The disease typically lasts for eight to 10 years, as it did with Reagan, before death. In some cases, patients live only a few years or as long as 20.

Alzheimer's patients don't die from the disease. Reagan, 93, succumbed to pneumonia, a common complication. A lack of nutrition that often comes with Alzheimer's makes patients susceptible to fatal infections.

The disease has made Nancy Reagan critical of the Bush administration's restrictions on federal money for embryonic stem cell research. At a fund-raising gala last month, she made a plea for stem cell research, describing how Alzheimer's had taken her husband "to a distant place where I can no longer reach him."

"I just don't see how we can turn our backs on this," she said.

Progress has been made in understanding Alzheimer's, but its exact cause is unknown. It is marked by plaque accumulating outside of brain cells and tangles of misplaced proteins inside.

Alzheimer's predominantly affects people over 65, and the risk increases with age. The number of people with the disease doubles every five years after 65, and nearly half of those 85 and older have it. Complications from Alzheimer's are the ninth-leading cause of death among those 65 or older.

Of those with the condition, 5 percent to 10 percent have the early-onset form, which can affect people in their 40s and 50s. Those whose parents or siblings have the disease are at an increased risk, although the genes involved aren't known.

It's not possible to predict how Alzheimer's will affect each person because the symptoms and rate of progression vary widely. A study in the Annals of Internal Medicine in April showed that women newly diagnosed continued to live a median of 5.7 years and men lived 4.2 years -- about half what a person of their age who didn't have the disease would be expected to live.

Eventually, people with Alzheimer's become increasingly dependent. They often stop recognizing members or their family or remembering how to perform basic skills such as dressing or eating. They may also become hostile to caretakers.

The drugs used to treat Alzheimer's are called cholinesterase inhibitors and glutamate receptor blockers. The first drug prevents the breakdown of a chemical messenger in the brain. The second, only recently approved by the Food and Drug Administration, blocks the overexcitation of brain cells.